Dr Ammar C Al Rikabi Dr Maha Arafah Respiratory block Pathology Lec 2 2020 Chronic Obstructive Pulmonary Diseases COPD Diseases of the Respiratory System Objectives Give introduction for diffuse lung disease ID: 1045102
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1. Diseases of the Respiratory SystemDr. Ammar C. Al-RikabiDr. Maha ArafahRespiratory block Pathology Lec 2 2020
2. Chronic Obstructive Pulmonary Diseases (COPD)Diseases of the Respiratory System
3. Objectives:Give introduction for diffuse lung disease Compare and contrast the major clinical and functional differences between predominant chronic bronchitis versus predominant emphysema in patients with COPD Define Bronchiectasis, its causes, presentation, morphology and significant.
4. Obstructive Lung DiseasesBronchial Asthma2) Chronic obstructive pulmonary disease (COPD) They are of two types: a) Chronic bronchitis b) Emphysema3) BronchiectasisCommon symptoms in lung diseaseDyspnea: difficulty with breathingCough Hemoptysis(diffuse) Obstructive lung disease
5. Chronic BronchitisDiseases of the Respiratory System Objectives:Define chronic bronchitis.Describe the causes, pathogenesis and the morphology of chronic bronchitis.Describe the mechanism of airway obstruction in a patient with chronic bronchitis. Understand that when severe obstruction is present in chronic bronchitis, significant emphysema is nearly always present
6. Chronic Bronchitis: defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive yearsChronic BronchitisCausesCigarette smoking is the most important risk factorAir pollutantsCystic fibrosis
7. Chronic bronchitisChronic Bronchitis: morphology
8. Chronic bronchitisChronic Bronchitis: morphology
9. Chronic bronchitis. In chronic bronchitis the main abnormality is secretion of abnormal amounts of mucus, causing plugging of the airway lumen (P).Chronic Bronchitis: morphology
10. Clinical features and compilcationsPersistent reproductive coughDyspnea on exertionHypercapnia, hypoxemia, cyanosisEmphysemaCor pulmonale Death due to further impairment of respiratory functions after superimposed acute baterial infections.Chronic Bronchitis
11. Chronic BronchitisDefinition: Persistent productive cough (with sputum) for at least 3 months in at least 2 consecutive years
12. EmphysemaDiseases of the Respiratory SystemObjectives:Define emphysema.Describe the gross and microscopic changes in emphysema.Discuss the typical clinical presentation and causes of death.Describe the most likely mechanism of emphysema (the protease-antiprotease mechanism). Describe the pathophysiologic mechanisms of emphysema
13. Emphysema Is abnormal permanent enlargement of all or part of the respiratory unit accompanied by destruction of their walls EmphysemaAssociated with loss of elastic recoil and support of small airways leading to tendency to collapse with obstruction
14. EmphysemaDiseases of Lung
15. Bullous emphysema with large apical and subpleural bullae
16. Distal acinar /paraseptal:forming multiple cyst-like structures with spontaneous pneumothorax.
17. Paraseptal emphysema, microscopicdestruction of alveolar walls
18. Pursed lip expiration is a common maneuver adopted by patients with severe chronic obstructive pulmonary disease including emphysema. The patient starts to breathe out closed or nearly closed lips to keep the intrabronchial pressure high and prevent collapse of the bronchial wall and expiratory obstruction. Later in expiration the lips are blown forwards and open, often with a grunt (“fish-mouth breathing).
19. Barrel-shaped chest in a patient with emphysema. The hyperinflation result fromair-trapping with inflammatory changeshypersecretion of viscid contraction in the small airways. Note the associated indrawing of the intercostal muscles. Similar changes are seen in patients with chronic bronchitis and asthma.
20. Pathogenesis of EmphysemaEmphysemaEmphysema: Pathogenesis
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22. Classification of emphysemaDiseases of Lung2. Alpha 1 antitrypsin deficiency:Commonly affect both lower lobesCentriacinar:in heavy smoker, severe in upper lobes 3.Distal acinar /paraseptal:adjacent to areas of fibrosis, scarring or atelectasisMore severe in the upper half of the lungs.4. IrregularAssociated with scarring, e.g. in TBAsymptomatic
23. Generalized emphysema. (a) Normal distal lung acinus. (b) Centriacinar emphysema. (c) Centriacinar emphysema. (d) Panacinar emphysema. (e) Panacinar emphysema (Gough-Wentworth section).Diseases of LungEmphysema: morphology
24. Emphysema: morphologyDestruction of some alveolar septi
25. Emphysema:Dilated air spaces beyond respiratory arteriolsEmphysema: SUMMARY
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27. BronchiectasisObjectives:DefinitionCausesPresentationmorphology and significant
28. Bronchiectasis is permenat dilatation of bronchi with destruction of their walls. It is a result of chronic inflammation associated with an inability to clear mucoid secretions. Bronchiectasis
29. Bronchial obstructionCongenital or hereditary conditions Chronic or severe infection / necrotizing pneumonia Localized: - tumor, foreign bodies or mucous impactionGeneralized: - bronchial asthma - chronic bronchitis - Congenital bronchiectasis - Cystic fibrosis. - Intralobar sequestration of the lung. - Immunodeficiency status. - Immotile cilia and kartagner syndromeCaused by TB, staphylococci or mixed infectionCauses of bronchiectasisus
30. Cilial dysmotility syndrome. Electron micrograph of cilia from a person with recurrent chest infections since childhood. The outer dynein arms are absent and there are abnormal single microtubules (M), which prevent normal motility.Diseases of Lung
31. Bronchiectasis, chest radiograph Presentation
32. Bronchiectasis, gross
33. Diseases of Lung Bronchiectasis Dilatation of bronchi with destruction of bronchial walls
34. Diseases of LungBronchiectasis. This is a lower lobe of lung surgically resected for bronchiectasis.
35. Bronchiectasis, micropscopic
36. Bronchiectasis:Dilatation and destruction of bronchi and bronchioles secondary to chronic inflammation and obstructionBronchiectasis
37. Diseases of LungLung abscess.
38. Key Facts Chronic obstructive pulmonary diseaseDiseases of Lung
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